Adenocarcinoma ex pleomorphic adenoma of the head and neck: Report of five cases

Nasopharyngeal Carcinoma Ex Pleomorphic Adenoma: Case Report and Comprehensive Literature Review

Carcinoma ex pleomorphic adenoma (CXPA) is an epithelial malignancy that transforms from benign pleomorphic adenomas (PA) at a rate of 1.5% after 5 years and 10% after 15 years. The average age of reported nasopharyngeal CXPA is 56.7 years. However, the present case describes a 19-year-old making this case exceptionally rare. Standard treatment is wide local excision with adjuvant treatment. We report the demographics, presentation, treatment, and outcomes of 8 cases of nasopharyngeal CXPA. While surgical excision is the mainstay of treatment, negative margins can be difficult to obtain at the skull base, and we report a recurrence rate of 50% in nasopharyngeal primaries. Due to the aggressive nature of the disease and high rate of recurrence, the majority of patients in our review received adjuvant radiation with some receiving adjuvant chemotherapy in addition.

Sinonasal/nasopharyngeal pleomorphic adenoma and carcinoma ex pleomorphic adenoma: a report of 17 surgical cases combined with a literature review

Objective: The aim of this study was to review demographic data, location, clinical symptoms, therapeutic methods, pathological features and relapse in sinonasal/nasopharyngeal pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (CXPA).

Methods: We conducted a retrospective analysis of 17 patients who were referred to our hospital during a 5-year period from 2013 to 2018.

Results: In this series, there were 7 males and 10 females. The tumors originated from the nasal septum in 4 cases, from the lateral wall of the nasal cavity in 2 cases, from the maxillary sinus in 1 case, and from the nasopharynx in 7 cases. The origin sites of 3 cases were not clear. The main symptoms were usually unilateral nasal congestion and epistaxis. All patients underwent endoscopic resection surgery. The postoperative period was uneventful. Ten patients were diagnosed with benign PA, and 7 patients were diagnosed with CXPA, including 5 cases of adenocarcinoma, 1 patient with mucoepidermoid carcinoma, and 1 patient with adenoid cystic carcinoma. After a mean follow-up period of 2.2 years (6 months–5.3 years), the recurrence rate of benign PA was 10% (1/10); the rate of malignant recurrence was 42.8% (3/7).

Conclusion: Sinonasal/nasopharyngeal PA and CXPA are rare neoplasms, and the most common primary site of PA and CXPA is the nasopharynx. As any salivary carcinoma type can arise in PA, these PA sites should be thoroughly sampled and closely examined to exclude the possibility of malignant transformation. Furthermore, PA and CXPA should be treated as soon as possible after definitive diagnosis, and endoscopic resection of tumor-negative margins may be helpful in preventing recurrence.

Nasopharyngeal Pleomorphic Adenoma: A Rare Case Report and Review of the Literature

Salivary gland tumors are rare among all head and neck tumors. Pleomorphic adenoma (PA) is the most commonly seen subtype, and 85% of the cases are located in the parotid gland. PA may very rarely be seen in minor salivary glands. Minor salivary gland PAs are mostly located in the hard and soft palates. Nasopharyngeal PA is very rare, and a total of 8 cases have been published to date. In this case report, a 51-year-old female patient who had nasopharyngeal PA with chondroid metaplasia is presented, and we review the relevant literature.

Benign tumors of the parotid gland: a retrospective study of 339 patients

AIM

Among 339 patients operated for benign tumor of the parotid gland: the recurrences and the postoperative complications rates were compared WITH those published in literature.

MATERIALS AND METHODS

About 339 patients operated: 274 primarily and 65 for recurrence or residual tumor.

VARIABLES

sex, age, surgical techniques, pre- or postoperative radiotherapy, histology, size and localization of the tumors, disease free intervals, recurrences and postoperative complications.

RESULTS

177 men and 162 women. Median age: 55 years and mean follow-up: 10.4 years. About 39 patients had adjuvant radiotherapy (11.5%). After primary surgery, four patients experienced recurrences (1.5%). After salvage surgery, eight patients recurred (12.3%). The recurrence rate was the highest among pleomorphic adenomas. Facial paralysis was more frequent after salvage surgery.

DISCUSSION

Recurrence rate 10 years later was lower after primary than after salvage surgery (p = 0.01). There was no relation between adjuvant radiotherapy and recurrence rate probably because the low rate of recurrences.

CONCLUSION

Recurrence rate after primary surgery is lower after superficial or total parotidectomy than after other surgical techniques. Pleomorphic adenomas have the highest rate of recurrences. Age and sex have no significant influence over the rate of recurrences. The most frequent postoperative complications are facial paralysis and Frey's syndrome.

[A case of giant pleomorphic adenoma of the parotid gland]

INTRODUCTION

A case of pleomorphic adenoma of the parotid gland was reported. Pleomorphic adenoma is the most common benign tumor of the major salivary glands. A review of the literature confirms that this kind of tumor is less common in the minor salivary glands. We described statistic population, types of the diagnostic, treatment and clinical course of pleomorphic adenoma of the parotid gland.

MATERIAL AND METHOD

We encountered such a tumor in a 55-year-old woman who was admitted to our Hospital. The only symptom was significant face deformation, growing for 30 years.

RESULTS

The tumor was located under the right side of the face and was removed surgically. No complications were observed in the postoperative course but paresis of the facial nerve occurred. The patient was discharged from the hospital with the recommendation of facial muscles rehabilitation. After the two months from the surgery, paresis was diminished. Afterwards contact with the patient got lost.

CONCLUSION

Pleomorphic adenoma is the most common benign tumor of the major salivary glands. Surgery is the main method of the treatment. The most common complication is paresis of the facial nerve.